Investigating the coverage of the Arkansas All-Payer Claims Database for examining health disparities related to persistent poverty areas in colorectal cancer patients.

IF 2.2 4区 医学 Q3 ONCOLOGY
Chenghui Li, Cheng Peng, Peter DelNero, Jonathan Laryea, Daniela Ramirez Aguilar, Güneş Koru, Yong-Moon Mark Park, Mahima Saini, Mario Schootman
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引用次数: 0

Abstract

Purpose: We aimed to (1) determine the extent of coverage of colorectal cancer patients in Arkansas All-Payer Claims Database (APCD), (2) assess coverage difference between persistent poverty and other areas, and (3) identify patient, tumor, and area factors associated with inclusion in APCD.

Methods: Data were from 2018 to 2020 Arkansas APCD linked with 2019 Arkansas Central Cancer Registry (ACCR). We constructed four cohorts to assess APCD's coverage of CRC patients: (Cohort 1) ≥ 1 day of medical coverage in APCD in 2019; (Cohort 2) APCD coverage in the diagnosis month; continuous APCD coverage in the 30; Year around diagnosis (six months before to five months after diagnosis month) (Cohort 3); or until death within six months (Cohort 4). We compared proportions in the cohorts by area persistent poverty designation. Logistic regressions identified factors associated with inclusion in APCD cohorts.

Patient selection: CRC patients diagnosed in 2019 from ACCR, excluding in situ disease.

Results: Of the 1,510 CRC patients diagnosed in 2019, 83% had ≥ 1 day of medical coverage in 2019 APCD (Cohort1), 81% had coverage in the diagnosis month (Cohort 2), and 63% had continuous coverage in the year around diagnosis (Cohort 3). Additionally, 11% died within six months but had continuous coverage until death (Cohort 4, 74%). No coverage difference was found between persist poverty and other areas. Age and primary payer type at diagnosis were the main predictors of inclusion in APCD.

Conclusion: Arkansas APCD had high coverage of Arkansas CRC patients. No selection bias by area of persistent poverty designation was present.

调查阿肯色州全付费者索赔数据库的覆盖范围,以研究结直肠癌患者中与持续贫困地区有关的健康差异。
目的:我们旨在(1)确定阿肯色州全付费者索赔数据库(APCD)对结直肠癌患者的覆盖范围;(2)评估持续贫困地区与其他地区的覆盖差异;(3)确定与纳入APCD相关的患者、肿瘤和地区因素:数据来自 2018 年至 2020 年阿肯色州 APCD 与 2019 年阿肯色州中央癌症登记处(ACCR)的链接。我们构建了四个队列来评估 APCD 对 CRC 患者的覆盖情况:(队列 1)2019 年 APCD 的医疗覆盖时间≥ 1 天;(队列 2)诊断当月 APCD 的覆盖时间;30 年内 APCD 的连续覆盖时间;诊断前后一年(诊断当月前 6 个月至诊断当月后 5 个月)(队列 3);或直到 6 个月内死亡(队列 4)。我们比较了不同地区持续贫困人口在队列中的比例。逻辑回归确定了纳入 APCD 队列的相关因素:患者选择:2019 年从 ACCR 诊断出的 CRC 患者,不包括原位疾病:在 2019 年确诊的 1510 名 CRC 患者中,83% 的患者在 2019 年 APCD(队列 1)中的医疗保险天数≥1 天,81% 的患者在确诊当月(队列 2)中有保险,63% 的患者在确诊前后一年中连续有保险(队列 3)。此外,有 11% 的人在 6 个月内死亡,但在死亡前一直享有保险(队列 4,74%)。在持续贫困地区和其他地区之间未发现覆盖率差异。年龄和诊断时的主要付款人类型是纳入 APCD 的主要预测因素:阿肯色州 APCD 对阿肯色州 CRC 患者的覆盖率很高。不存在持续贫困地区的选择偏差。
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来源期刊
Cancer Causes & Control
Cancer Causes & Control 医学-公共卫生、环境卫生与职业卫生
CiteScore
3.90
自引率
4.30%
发文量
130
审稿时长
6.6 months
期刊介绍: Cancer Causes & Control is an international refereed journal that both reports and stimulates new avenues of investigation into the causes, control, and subsequent prevention of cancer. By drawing together related information published currently in a diverse range of biological and medical journals, it has a multidisciplinary and multinational approach. The scope of the journal includes: variation in cancer distribution within and between populations; factors associated with cancer risk; preventive and therapeutic interventions on a population scale; economic, demographic, and health-policy implications of cancer; and related methodological issues. The emphasis is on speed of publication. The journal will normally publish within 30 to 60 days of acceptance of manuscripts. Cancer Causes & Control publishes Original Articles, Reviews, Commentaries, Opinions, Short Communications and Letters to the Editor which will have direct relevance to researchers and practitioners working in epidemiology, medical statistics, cancer biology, health education, medical economics and related fields. The journal also contains significant information for government agencies concerned with cancer research, control and policy.
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